Individual
BRIAN ANTHONY PRUDENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1828 AVENUE OF THE CITIES, MOLINE, IL 61265-4858
(309) 764-0008
(309) 764-0059
Mailing address
1828 AVENUE OF THE CITIES, MOLINE, IL 61265-4858
(309) 764-0008
(309) 764-0059
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.025580
IL
Other
Enumeration date
01/25/2007
Last updated
05/29/2015
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